The object of this three year project is to design, implement and evaluate a computer assisted PATIENT CARE QUALITY ASSURANCE SYSTEM (PACQAS), which can be overlayed on an existing Medical Information System (MIS). The existing system is operational and cost-effective in a community hospital such that the PACQAS can be operated at low marginal cost utilizing the existing data base and computer power. The proposed system will be composed of four subsystems: (1) A computer-assisted diagnosis-particular, outcome-oriented Nursing Care Planning Subsystem, which was successfully implemented on three units in Year I. Hospital-wide implementation on general nursing units will be completed in Year II. (2) A computer-assisted Patient Care Audit Subsystem, which integrates both concurrent and retrospective aspects of nursing, medical and utilization audits into a coordinated patient care audit. A nursing care outcomes audit, a combined medical/nursing audit using generic criteria, and a care planning audit were developed in Year I. (3) A computerized Patient Care Plan Based Staffing Requirements Subsystem will be developed in Year II. (4) A computerized Services Coordination Subsystem for patient scheduling/services coordination from pre-admission through discharge will be developed. Pre-admission ordering/reporting capabilities were incorporated in Year I.